Solitary Fibrous Tumors of The Pleura: Our Experience

Introduction: Solitary fibrous tumors (SFT) of the pleura are rare and potentially malignant (5% of pleural neoplasm). Methods: From June 1988 to April 2006 18 patients underwent 21 surgical procedures. 6 males and 12 females; median age was 60 years (range 39–72). Predominant clinical symptoms were dyspnoea, chest pain and cough in 12 cases, hypoglycemia in 2, 6 patients were asymptomatic. Surgical approach was through posterolateral thoracotomy in 11 patients, lateral thoracotomy in 4 and VATS in 6. 14 tumours arose from visceral pleura, 7 from mediastinal, diaphrag- matic and parietal pleura. Removal of the tumor alone was possible in 1 case, in the remaining extended resection involving adjacent structures was performed (1 bilobectomy, 3 lobectomies, 14 wedge and 1 chest-wall resection, 4 diaphragmatic resections). In all cases radical surgical excision was achieved. Results: There was no perioperative mortality or morbidity. All surgical specimens were histologically proven to be a localized benign tumor of the pleura. Immunohistochemical reactions were in 16 patients positive for CD34, negative for vimentin, S100, cytoker- atin. Follow up was performed in 17 patients (range 17 years–10 months). Local recurrences occurred in 3 cases, in which sarcomatous degeneration was observed. 14 patients are still alive without evi- dence of disease, 3 are dead of disease. Discussion: Even though the majority of SFT are benign, they should be considered as potentially malignant neoplasms. Radical resection as well as clinical and radiological follow up are highly recommended because of the potentially malignant biological behaviour and the lack of radical treatment options.